Comparison of Proposed Modified and Original Sequential Organ Failure Assessment Scores in Predicting ICU Mortality:
Afshin Gholipour Baradari1, Hassan Sharifi2, Abolfazl Firouzian1
1Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Abstract:
Background. The sequential organ failure assessment (SOFA) score has been recommended to triage critically ill patients in the intensive care unit (ICU). This study aimed to compare the performance of our proposed MSOFA and original SOFA scores in predicting ICU mortality. Methods. This prospective observational study was conducted on 250 patients admitted to the ICU. Both tools scores were calculated at the beginning, 24 hours of ICU admission, and 48 hours of ICU admission. Diagnostic odds ratio and receiver operating characteristic (ROC) curve were used to compare the two scores. Results. MSOFA and SOFA predicted mortality similarly with an area under the ROC curve of 0.837, 0.992, and 0.977 for MSOFA 1, MSOFA 2, and MSOFA 3, respectively, and 0.857, 0.988, and 0.988 for SOFA 1, SOFA 2, and SOFA 3, respectively. The sensitivity and specificity of MSOFA 1 in cut-off point 8 were 82.9% and 68.4%, respectively, MSOFA 2 in cut-off point 9.5 were 94.7% and 97.1%, respectively, and MSOFA 3 in cut-off point of 9.3 were 97.4% and 93.1%, respectively. There was a significant positive correlation between the MSOFA 1 and the SOFA 1 (r: 0.942), 24 hours (r: 0.972), and 48 hours (r: 0.960). Conclusion. The proposed MSOFA and the SOFA scores had high diagnostic accuracy, sensitivity, and specificity for predicting mortality.
Insights
The MSOFA score shows high accuracy in predicting ICU mortality, performing similarly to the SOFA score. This modified score offers a reliable tool for assessing critically ill patients.
Area of Science:
- Critical Care Medicine
- Clinical Scoring Systems
- Prognostic Biomarkers
Background:
- The Sequential Organ Failure Assessment (SOFA) score is a standard for triaging intensive care unit (ICU) patients.
- Accurate prediction of ICU mortality is crucial for patient management and resource allocation.
- Evaluating novel scoring systems can improve prognostic capabilities.
Purpose of the Study:
- To compare the predictive performance of a proposed MSOFA score against the original SOFA score for ICU mortality.
- To assess the diagnostic accuracy, sensitivity, and specificity of both scoring systems.
Main Methods:
- A prospective observational study involving 250 ICU patients.
- Calculation of MSOFA and SOFA scores at ICU admission, 24 hours, and 48 hours.
- Utilized diagnostic odds ratio and receiver operating characteristic (ROC) curves for comparative analysis.
Main Results:
- Both MSOFA and SOFA demonstrated high accuracy in predicting mortality, with areas under the ROC curve exceeding 0.83 for MSOFA and 0.85 for SOFA across different time points.
- MSOFA scores showed high sensitivity and specificity, particularly at specific cut-off points (e.g., MSOFA 2 at 9.5: 94.7% sensitivity, 97.1% specificity).
- A strong positive correlation (r > 0.94) was observed between MSOFA and SOFA scores at all measured intervals.
Conclusions:
- The proposed MSOFA score exhibits high diagnostic accuracy, sensitivity, and specificity for predicting ICU mortality.
- MSOFA demonstrates comparable performance to the established SOFA score, suggesting its potential utility in clinical practice.
- Both scoring systems are effective tools for prognostication in critically ill patients.